Ponticello, Mario Natale

Ponticello, Mario Natale is an individual health care provider with primary practice located at 9040 Jackson Ave , Tacoma WA 98431-0001. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Ponticello, Mario Natale can be contacted via phone (253) 968-3505.

Contact Information

Primary practice address
9040 Jackson Ave Tacoma WA 98431-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 950-25 Wisconsin

Profile Details

NPI number 1134395734
LBN Legal business name Ponticello, Mario Natale
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2008
Last updated Jan 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134395734 NPPES
Wisconsin Other P00695367 RAIL ROAD MEDICARE
Wisconsin MEDICAID 43244600 RAIL ROAD MEDICARE

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